CE Providers React to NCBTMB’s New Approval Plan

In the past couple of weeks since the NCBTMB unveiled their new plan for CE providers, which includes doing away with organizational approval, the reaction of providers has for the most part been very negative–and frankly I’m not surprised. The long-standing organizations who are providing quality continuing education approved feel, for the most part, that the organization they have supported for many years is throwing them under the bus.

Some of the main concerns that I  have heard are from providers who have created proprietary classes and who have trained and approved their own instructors to go out and teach their work. They are now faced with the instructors that they have invested time and money in training and marketing classes for going out on their own, taking copyrighted teaching manuals and proprietary handouts with them, and acting as if they are under no obligation pay the percentage or per-student charge that they have agreed to pay as teaching members of the organizations. Those same instructors who have been mentored and marketed under our organizations are now saying “we’ll just be out on our own after 2014.” They are making it clear that they feel free to take our proprietary materials away with them—because the new rules are basically blessing that—and never give the organization that put them where they are another dime.

Those who have organizational approval do not want unqualified people teaching for their organizations and misrepresenting their good names, and have gone to considerable effort and expense to make sure that is not the case. While there is certainly nothing wrong with requiring us to provide proof of that, taking all instructors from under our organizational umbrella and putting them out there on their own is also going to create logistical nightmares. The organization has been responsible for collecting and maintaining registration forms, evaluation forms, etc. and issuing CE. In the case of Upledger, for example, now instead of one organization handling those administrative tasks, there will be more than 100 separate instructors keeping up with that. The organization will have no control and no more quality assurance that they will be able to exercise.

The organizations and schools that sponsor CE workshops at the national, state, and local levels will suffer from these changes as well. This is also financially crippling and over-burdensome to smaller organizations who may not teach that many classes each year. When it comes to education, quality and quantity are not the same thing.

The notion that having people turn in all their lesson plans as proof that they are a competent teacher is also flawed. My publisher hires me to write lesson plans all the time to go with their textbooks and for career schools who want customized plans. I’ve written at least 20 this year alone. If you have the money to hire me, I will write one for you. It still will not make you a competent teacher. A well-written lesson plan doesn’t necessarily indicate that you’re a great teacher; it indicates that you are either a competent writer, or that you hired someone like me to write it for you. Requiring people to send in a video of themselves teaching would be more indicative of whether or not they are competent, since the organization obviously cannot afford to vet every class in person.

In response to the outcry since the NCBTMB announced the plan, they have stated that they will consider some of these issues on a case-by-case basis. I would like to know how they plan to carry that out with volunteers—volunteers whose qualifications to judge us we have no knowledge of, as they are not releasing the names of the people on that committee. Are they experienced educators? Are they trained in teaching methodology? Are the research literate? We don’t know; we can only hope so.

I find it necessary to bring up that the reason the NCBTMB changed from vetting individual classes years ago was because the task became too overwhelming for the paid staff to handle and getting volunteers together to do it caused the process to move at the pace of molasses. It is unacceptable for someone to wait six months—as has been common at several points in time—to get their approval or denial. It is very apparent from the latest 990 filing that the NCBTMB cannot afford to hire new staff and that they will indeed be depending on volunteers until such time as this might generate enough money to enable that. This is one of the service problems that has come very close to knocking this organization to its knees in the past, and they do not need to go backwards instead of forward.

Considering things on a “case-by-case” basis also leaves this organization open to accusations of favoritism, if not worse. The massage community is a tight-knit and close community, in spite of the fact that there are thousands of us. Those of us who are organizational providers tend to attend the same events, and travel in the same circles. What you allow for one, you must allow for all. To do otherwise is simply unethical and unprofessional, and the first time it comes to light, and it certainly will, that any consideration given to one has not been given to all, it is going to be another public relations nightmare for the NCBTMB. I don’t think they can stand to have many more of those.

Let’s look at a few facts.

There are currently a half dozen states with their own CE approval process. The NCBTMB is not the only game in town…and it is that same complacency of thinking that has resulted in the FSMTB kicking their butt with the MBLEx. I would not fall into the mistake of thinking that the Federation isn’t willing to step up and do something about CE approval as well. They may seize upon the dissatisfaction of the current environment; they already have the infrastructure, and big cash reserves at their disposal. The Federation doesn’t “need” the money, and the perception here from providers is that the NCBTMB is trying to bail themselves out of the red with this plan.

There is no evidence to support that regulation, including requiring CE, has contributed to the safety of the public. There have always been unethical and incompetent practitioners, and for that matter unethical and/or incompetent CE providers, and they will continue to exist, regardless of the amount of rules and regulations. Look at how things stand in other professions. There are 17 states that don’t require nurses to obtain CE. There are 10 states that don’t require PTs to obtain CE. Even MDs have 7 states that don’t require them to obtain CE—but all three of these professions are licensed in all 50 states.

Other than the 30 or so of us (including myself) who were present at the meeting the NCBTMB convened in Chicago to discuss this issue a couple of years ago, there has been no attempt to gather the input of the (hundreds of) providers that are currently under the auspices of the NCBTMB.  I believe this organization is in need of our support, not our animosity and distress.

I urge them to abandon this plan, and gather input from a much broader slice of the profession before considering such drastic measures again.

The Financial Health of Our Organizations: FSMTB

Note: For the past few years I have done a series of reports on the financial status of the non-profit organizations that represent the massage therapy profession. I obtain this information from Guidestar, a financial information clearinghouse for non-profits. The organizations can provide their Form 990 (Return of Organization Exempt from Income Tax) to Guidestar, and if they don’t, the IRS does it for them. I will state for the record that I am not an accountant or a financial analyst; I just report what I see (and maybe offer a few opinions). I usually get asked the question every year why I am not reporting on ABMP. Associated Bodywork & Massage Professionals is a privately-owned for-profit company, and they are not obligated to release their financial information. Non-profits are on a different filing schedule than the rest of us, and there is variance amongst them in when their fiscal year ends. The deadline for filing is the 15th day of the fifth month after the end of their fiscal year. An organization can also request and receive up to two 90-day extensions, and due to the number who haven’t filed yet for 2011, it appears that some of them have done that.

It’s business as usual at the Federation of State Massage Therapy Boards…they’re rolling in the dough, and they appear to be immune to the slow economy. For the fiscal year ending 06/30/2011, they are showing a total gross revenue of over $4.3 million, well over a million dollars up from the previous year. Their total assets increased in a year’s time by almost $1.3 million, while their liabilities went down to less than $16,000—down from over $218,000 the previous year. Their net revenue after expenses is almost $1.5 million, up over $490K since the previous year. Their theme song could be “We’re in the money.”

One difference in the Federation and other organizations is that their Board members do not receive any reportable compensation. The only compensation listed on the form for key personnel is that of Executive Director Debra Persinger, who was paid $196,324 and received an additional $23,039, which is just listed as “other compensation from the organization and related organizations.” I’ve heard through the grapevine that she has received a big raise since this form was filed, but I guess we won’t know until next year. They do show about $24K in other salaries; I assume that is the office assistant. They don’t have a big staff.

I have to say that I find it a little bit funny that they only spent $5500 on advertising. I spent more than twice that advertising my massage business. “Occupancy” is listed as over $19,000; and travel is listed at a little over $14K. While I realize the need to travel to meetings and conventions, I will say one thing. When the FSMTB first came on the scene, they were very critical of the NCBTMB spending the stakeholder’s money holding meetings in fancy places….so I personally think they ought to police themselves a little more. This year, I hear they had a meeting in the Trump Tower in Manhattan–not exactly the Holiday Inn, I imagine.

Other than Persinger’s salary, their primary expenses are over $1.2 million paid to Pearson Vue for exam delivery, almost $900K to PCS for exam processing, and a little over $110K to Meaningful Measurement for exam development. Their office expenses were only about $15K.

No need to bore you with line-by-line details. I’ll just say the Federation is the poster child for being in good financial shape and let it go with that.

The Financial Health of Our Organizations: NCBTMB

Note: For the past few years I have done a series of reports on the financial status of the non-profit organizations that represent the massage therapy profession. I obtain this information from Guidestar, a financial information clearinghouse for non-profits. The organizations can provide their Form 990 (Return of Organization Exempt from Income Tax) to Guidestar, and if they don’t, the IRS does it for them. I will state for the record that I am not an accountant or a financial analyst; I just report what I see (and maybe offer a few opinions). I usually get asked the question every year why I am not reporting on ABMP. Associated Bodywork & Massage Professionals is a privately-owned for-profit company, and they are not obligated to release their financial information. Non-profits are on a different filing schedule than the rest of us, and there is variance amongst them in when their fiscal year ends. The deadline for filing is the 15th day of the fifth month after the end of their fiscal year. An organization can also request and receive up to two 90-day extensions, and due to the number who haven’t filed yet for 2011, it appears that some of them have done that.

The National Certification Board for Therapeutic Massage & Bodywork has filed their 2011 Form 990 in a timely manner so I’m going to start with them this year. I’ll be following that up with my report on the Federation of State Massage Therapy Boards. The financial status of these two organizations are intertwined for one reason: since it’s introduction in 2008, the MBLEx has taken a substantial market share of the entry-level exam market away from the NCBTMB. For many years, the NCBTMB exams were enjoying a monopoly, except for the few states that require their own exam.

In 2008, the first year that the MBLEx was available, the NCBTMB’s revenue from exams was in excess of $6 million. By 2011, that had dropped to $3,380,813. Instead of a monopoly, they had a 47% share of the market. I confess that I was expecting it to be even less, since the Federation has relentlessly encouraged their member states to use the MBLEx exclusively. I think the fact that the NCBTMB has retained as much as they have is proof that plan has not yet come to fruition. The income at the NCBTMB from people recertifying dropped by a little over $5k, and sales of their exam guide were down about $17k. Sales of their mailing list also took about a $20k hit this year.

They are showing a total revenue of $5,357,738 for 2011. From 2010 to 2011, the NCBTMB’s total revenue went down to the tune of $443,312. That’s not exactly a shocking figure in this time of recent recession.

The 2011 return, due to the timing of the NCB’s fiscal year, reports the salary of former CEO Paul Lindamood; although the filing was signed by his replacement Mike Williams. Lindamood’s compensation and benefits amounted to over $257,000. No word on what Mike Williams is doing the job for. Non-profits have to report the breakdown of compensation of officers, directors, trustees, key employees, highest compensated employees, and independent contractors. All together, the NCBTMB paid out over $1.7 million in compensation during 2011. Their other major expense is over $1.3 million in exam administration fees.

The bottom line is what tells the tale for most businesses–for profit or not–and their net revenue after expenses for 2011 is $227,326 which is down over $240,000 from 2010.When you consider that during Paul Lindamood’s reign at the helm, the organization went from being almost $270,000 in the hole in 2009 to having a net income of over $469,000 in 2010, it looks like it’s time to either slash expenses, the way he did, or generate more money.

That’s exactly what the NCBTMB hopes will happen in the coming year(s) on both fronts. They are rolling out the new rules for national certification, as well as the new rules for continuing ed providers, and doing away with organizational approval. The requirement that each individual be approved as a provider in their own right should generate some additional funds. The new rules for becoming nationally certified, in my humble opinion, is initially going to cause a further decrease for them. Since the new rules are jacking up the education requirement from 500 hours to 750, and requiring 250 hours of work experience, that will automatically disqualify people who might have otherwise taken the exam for entry-level licensing. The NESL is still an option in some states, but with the entry-level exam revenue steadily declining for the past four years, and the MBLEx becoming more firmly entrenched with the member states as time goes on, I’d be surprised if they don’t continue to lose ground in that market.

Their expenses could go back down. The application and recertification processes are online, and that’s going to knock a few staff members out of a job. They spent about $40k more in 2011 attending conventions than in 2010. I feel that they should be present at all major massage meetings, so I don’t begrudge that money…conventions are never held at Motel 6 so unless I’m an invited speaker, I feel that one in my own pocketbook. Legal expenses also increased by about $13k this year, but lobbying decreased by almost that same amount. It does cost money to go in and challenge a state that is considering dropping your exam–or appealing to one that has already dropped it to reinstate it.

On a positive note, total assets increased by about $70k, while total liabilities decreased by about $142,000.

All in all, it wasn’t the best year they’ve ever had–and it wasn’t the worst, either. The NCBTMB has had some administrations in years gone by that seemed hellbent on bankrupting the organization. I feel pretty safe in saying that isn’t the case here; they have some dedicated staff and board members that are determined to make it work, and we’ll just have to wait and see what happens. In the meantime, their new website is very snappy. You can check it out and all the new changes they are implementing at www.ncbtmb.org

NCBTMB Making Major Changes to CE Provider Approvals

Disclosure: I have agreed to pass along comments, questions and concerns to the NCBTMB on this matter, and the management there reads my blog. They are fully aware that I use this blog to express my own opinion whether it is in line with theirs or not. Your comments here will be seen by the CEO, Mike Williams, and the Board of Directors. 

UPDATE 09/18/2025: Documents that were linked in the original blog post are no longer available.

The NCBTMB has announced major changes in the works to their Approved Provider program for continuing education.

As soon as they sent out the press release I started getting emails and FB messages from people asking questions about it, some applauding it, and some complaining about it. The biggest change is that they will no longer be offering organizational approval. Every individual who teaches a continuing education class will need to obtain individual approval as a provider. That’s going to affect a LOT of entities: AMTA, the American Massage Conference, massage schools, and other organizations who have previously been able to take people in under their umbrella.

It’s affecting me, personally. I have organizational approval myself. I normally host a dozen or more teachers at my facility each year, and while 90% of them are approved providers in their own right, a couple are not. I don’t perceive it to be such a big deal for me…it’s not going to be a problem for them to get their own approval, and I have until the end of 2013 to prod them along into doing so. All who are approved as organizations have until the end of 2013 to get your act together and come into compliance under the new rules.

One of the first complaints, naturally, was about money, and people having to pay yet another expense. Organizational approval up to this point has cost $400. In reality, an organization that only has two teachers has been paying the same amount as one that has twenty, and that’s not really fair. Under the new paradigm, approvals will cost $175 and will last for three years. You must also pay a $25 fee for each class you submit to be reviewed. As a clarification to one point that has been brought up, if you have a full class and you teach portions of that, as sometimes happens at conferences and conventions, you are not having to pay $25 for each version of it…just the one fee. That’s good. I teach for a lot of AMTA chapters and I am often asked to cut an 8 hour class down to 6 hours or make a 3 hour class last for 4, so it’s good to know you’re not paying $25 for all derivatives of the same course.

People have also stated issues with them requiring a criminal background check. Some state boards require that, and some don’t. My particular state does, and if memory serves I think the fee is $30 or $35. It may be duplicating efforts for the NCBTMB to require it in some instances, but not in others.

I have personally had discussions with the powers that be at the NCBTMB over the approval of course content. They are now vetting individual courses again–to a point. The first concern I got wind of was from a colleague who was concerned that they would throw out everything that doesn’t fit in the box of Western medicine. Have no fear. My own wish is that they would get rid of some of the more questionable classes that are approved….at least they were questionable to me, and of course, I’m just one person with an opinion in a sea of many.

They have no intent of getting rid of energy work courses and other classes that don’t have any basis in science…as long as the course content shows some connection to or lineage from massage, it will still likely be approved. I say likely because during the vetting process, they are paying more attention to quality, whatever that truly means. For one thing, they are asking you to turn in your complete handouts, which has never been done before and which also has some people concerned about letting their proprietary information out of the bag. I have expressed my own concern that some of these courses people have invented that don’t have any basis in science and in fact have in some instances been proven to be totally contrary to accepted scientific principles are still going to be approved, so I’m not sure how “quality” that is. A lot of people disagree with me on that front. There is obviously a very huge demand for those types of classes, or they wouldn’t continue to exist.

What I would personally like to see happen is a national certification for science-based education. I’m going to keep after them about that; you can count on it. People can do all the unsubstantiated things they like, but there are some who would like to have a credential that is based on the actual evidence-informed practice of massage. I am one of them. Does that mean I am claiming to be better than you? No, it does not. It just means I would like for there to be something out there that differentiates those who want to be known as evidence-based practitioners as opposed to those who don’t.

Other questions I’ve been asked include exactly who is doing this, and the names of the committee members have not been released that I am aware of. They just state on their website (which is new and snappy-looking, incidentally) that it is a team of experienced practitioners and educators.

People ought to be aware that the buck doesn’t really stop with the NCBTMB. They, along with numerous other certification agencies,  are accredited by the Institute for Credentialing Excellence (formerly NCCA, National Commission for Certified Agencies).  They are the only national accreditation body for private certification organizations, in all disciplines, to demonstrate adherence to established standards. Among the certifying agencies that this organization accredits include healthcare programs in chiropractic, dentistry, EMT, nursing, medical assisting, nutrition, prosthetics and orthotics, and pharmacy. They also accredit certification programs in the arts, construction trades, and a host of other things. And ICE is accountable to the Council for Higher Education.

Bottom line: changes are coming, and you can either go with the flow or go away…while a few states have their own approval process, the vast majority still depend on the NCBTMB for approving continuing education.

I’d like to state for the record that I personally am acquainted with the majority of the people at the NCBTMB, and I have certainly written my share of criticism of the organization in the past–and patted them on the back when I thought they deserved it. The fact is that if they stand on their head and whistle Dixie, it is never going to suit all of the people all of the time. I think they are a dedicated and hard-working group of people. I certainly don’t agree with everything they do, and I take frequent advantage of my status as a certificant and an approved provider to let them know that.

Here’s your opportunity to comment, so take it. As I said, these comments will be seen by the CEO and Board members.

AMTA Pledges $100,000 in Matching Donations for MTs Affected by Hurricane Sandy

The American Massage Therapy Association announced today that the organization is pledging a matching donation of up to $100,000 to help massage therapists who were affected by the storm in NY, NJ, and CT. In the press release issued earlier today, in addition to the matching donation, member therapists will also be given a payment plan for their membership dues, and provided with free continuing education.

In the next few days, there will be a page on AMTA’s website where you can make a donation electronically. In the meantime, donations should be sent to AMTA, 500 Davis Street, Evanston,IL 60201 and mark on the check that it is for the Hurricane Sandy Account.

AMTA chapters throughout the U.S. are encouraged to provide assistance to massage therapists through AMTA’s Hurricane Sandy account.

AMTA members and all massage therapists also can contribute to this account. (Note that contributions to AMTA chapters or to the Hurricane Sandy account are not tax-deductible, as AMTA is not a charitable organization.)

Contribute directly to those agencies and groups established to accept charitable contributions and ensure that they reach those most in need.

For several days after the hurricane, AMTA reached out to learn more about the impact of the storm on massage therapists. Lack of electricity and communications in most of the area dramatically slowed the ability to learn who was affected. Once we established contact with chapter presidents in the Tri-State area, the AMTA Board was better able to determine what it could do as a professional association to benefit massage therapists and the profession.

There have been some grassroots efforts going on in the interim, and no one is minimizing those efforts. Friends have helped friends–and perfect strangers–and neighbors have helped neighbors. I’d like to say, though, that double the money is double the money–so I encourage you to give where it’s going to be doubled and do twice the good. AMTA has the safeguards in place of having a bank account strictly dedicated to this cause set up, and complete accountability of the funds coming in and going out.

Blessings to all those who have been affected, and all those who are doing what they can to help. Now let’s get this $100,000 raised so we can turn it into $200,000.

Come to COMTA

I just got home from doing a site review from COMTA. It was my third trip as a peer reviewer, and once again, an enlightening experience. COMTA is the Commission on Massage Therapy Accreditation. Gaining accreditation is a strictly voluntary process. It’s estimated that there are about 1500 massage schools/programs in the US, and less than 100 of them possess the accreditation. Obtaining COMTA accreditation for a massage school is not cheap, and it’s a lot of hard work, so you might wonder why a school would do it. After getting acquainted with all the ins and outs of it, the answer, to me, is that it’s a  hallmark of excellence. It’s a way to say “We’re going beyond what the state requires to prove that we have a superior school.”

Part of the accreditation process is a very thorough self-study report. Schools must review their policies, their procedures, the way they conduct business, the education they provide. If it’s not documented, it doesn’t exist. As a peer reviewer, my job is to study their documentation before getting to the site, and then doing an actual visit to the school. Every syllabus, every lesson plan, every piece of documentation related to their educational process and their business proceedings is reviewed. The curriculum needs to fall in line with the mission statement. The education offered must match the learning objectives that are stated. When the reviewers show up for the site visit, we basically review every piece of documentation they claim to have, to make sure it actually exists and to make sure it does what it claims to be doing.

The accreditation doesn’t just earn a nice label for the school. It provides a measure of protection to the student, as well. It assures that the school has definite policies on qualifications for insuring the competency of instructors, absenteeism, grading, following a carefully thought-out lesson plan, and much more. It assures that financial aid is being administered correctly and that student finances are carefully documented. It assures that their are policies on sexual harassment, and that instructors have to continually improve themselves with technical training and continuing education.

A COMTA school can’t rest on their laurels. It’s an ongoing process of maintaining the standards, and regular review. A school that is poorly managed isn’t going to cut the mustard. It’s safe to say there aren’t any diploma mills or haphazardly run schools among the ranks.

COMTA standards are on the organization’s website. Anyone can access them. I challenge every single school owner in the country to review them one at a time, and see how your school stacks up. Take the leap and apply for accreditation. When we review your documentation and show up for a site visit, we’re not there to thump you on the head for any shortcomings; we’re there to help you come into compliance with the highest standards in the massage profession.

COMTA is also always seeking competent peer reviewers. The training to be a reviewer is also available on the website. Visit www.comta.org, and come to COMTA.

 

The ELAP Flap Continues

Earlier this week I received the ELAP (Entry-Level Analysis Project) Description from ABMP. I’ve been blogging about this for several weeks, first because I was upset that it was shrouded in secrecy; then last week because I finally got word of who is serving on this work group. While that information didn’t exactly smooth my ruffled feathers, I was gratified to see that I know some of the people working on it and know that they do the best job they can at whatever tasks they take on. And the document has changed quite a bit from the first proposal I saw, which I had numerous objections to (see previous blogs under this one). That being said, I’m still not thrilled with it.

I feel that there are some big pieces missing here, and that the profession would be better served by pointing resources in a different direction. To begin with, the document makes the point that how regulatory agencies arrived at the 500-hour minimum that has been a benchmark of entry-level education is unknown…that’s true, but it’s also unknown of how states with more hours arrived at those requirements. One thing that’s mentioned is the influence of federal financial aid, which presumably has led some schools  to offer more hours (or states to require them). As is the case with a lot of things, following the money trail often gives insight into real motivation.

Personally, I don’t think financial aid, or the lack of it, should be influencing this project at all. As a former school administrator, I’ve been involved in the financial aid process first-hand in the past. Whenever a recession and massive job layoffs happen, as they have here in my home state for the past three years or so, there’s a phenomenon that occurs. There’s an influx of displaced workers into the community college system, where financial aid is a given, and I’ve been told by students who had never even considered massage as a career that “the job counselor said I could get my schooling paid for if I would study massage.” That’s just not the reason I want to see people coming into the profession.

I feel there are some other tasks that need to be completed before anything like this is undertaken. The ELAP description states only two goals, one of which is to assess how many program hours are needed to attain this KSA (knowledge, skills, and abilities) goal, assuming capable instruction.

That’s a major issue, in my opinion—because you can’t and shouldn’t assume capable instruction. The Alliance for Massage Therapy Education is working on a National Teacher Education Standards Project to define the KSAs needed by teachers, both entry-level and more experienced/advanced. There is also a line-by-line review of the MTBOK going on. To charge headlong into the ELAP before these two initiatives are complete seems like putting the cart before the horse.  In all fairness, I am glad to see our organizations collaborating instead of refusing to play nice, but I would prefer to see them applying their resources to the National Teacher Education Standards project. The ELAP claims to be addressing what it takes to make a therapist able to practice competently. The fact is if the teachers aren’t competent in a 500-hour program, they’re not going to be any more competent in a 750-hour program until they are educated. We need educators who are competent enough to teach competencies, not just stand in front of a classroom for a longer number of hours.

Part of the rationale for this entire undertaking is the perceived  lack of competence of entry-level therapists. While the FSMTB is about to launch a new Job Task Analysis Survey, and the NCBTMB recently did the same, we ought to bear in mind what it is that a JTA shows. They tend to be snapshots of a day in the life of a massage therapist: see the clients, do the laundry, keep up the paperwork. If the perception is that therapists are not doing what they need to do in order to keep the public safe and practice competently, is asking them what they do all day really effective for this purpose? I don’t think it is. As one of the comments on last week’s blog said, “They don’t know what they don’t know.” There will be also be an accompanying survey within the JTA survey, intended to eliminate the “experience bias” present in these types of surveys, but I think that’s a tricky proposition. The return rate on these surveys tend to be very small–and usually answered by the minority of us who actually give a rip about the state of things. JTA surveys tend to be long and somewhat boring and it’s a very small percentage of people who will even fill them out to begin with.

Reportedly, the ELAP project was conceived to help address the problem of portability of massage between the states. One of the statements reads in part “we need to identify the key KSAs required to pass a national licensing exam and provide competent, safe massage in an early massage career.”

Right there is another problem. While the FSMTB would like to see every state exclusively using the MBLEx, it hasn’t yet happened. Since the NCBTMB is increasing the requirements for National Certification, leaving them with only the NESL options for entry-level exams in the states that accept those, the MBLEx will undoubtedly become exclusive in some places, but New York is not going to throw over their exam for the MBLEx, in my opinion. There is no such thing as national licensing, and there is never going to be. National licensing doesn’t exist in any profession I am aware of. If you’re a doctor, you still have to get licensed in each state in which you want to practice. While portability is a pain in the butt for massage therapists, it has never been shown to be harmful to the public or to the profession on the whole. Inconvenient, yes; but harmful, no.

The FSMTB is also working on the Model Practice Act, as mentioned in the ELAP description. While I wouldn’t go so far as to say it’s a waste of time, I don’t expect any influx of the regulated states lining up to change their existing practice acts to whatever the FSMTB comes up with. I’m sure it will be a helpful guideline for the unregulated states if and when they decide to join the fold, but it will be interesting to see how that document ends up harmonizing with the ELAP. Since the MBLEx has been an exam that uses the 500-hour threshold (and in fact, you can take that exam at any point during your education, prior to graduation), if this project somehow demonstrates that more hours are needed, is the FSMTB going to jack up the requirement to sit for the MBLEx? The Model Practice Act project was also undertaken prior to the ELAP project starting up, and while I haven’t seen a draft and don’t know what it includes, my prior knowledge of state practice acts demonstrates that those generally spell out required education and the breakdown of those hours, so presumably the ELAP would affect the Model Practice Act project as well.

Another part of the hoped-for result of this project is to cut down on the number of lawsuits and ethics complaints against entry-level massage therapists. Personally, I believe someone who is going to act unethically is going to do it regardless of how much education they have. When it comes right down to it, the injuries resulting from massage are a tiny fraction of what they are in other health-care related fields. I’m not saying there aren’t any, but on the whole it’s relatively insignificant when compared to the number of practitioners.

Lest anyone think I am against raising the standards of the profession on general principles, that’s not so. I don’t own a school, and I’m already licensed, so it’s not like this is going to inconvenience me personally. In fact, a few years ago when I was on the North Carolina Board of Massage & Bodywork Therapy, we looked at raising the hour requirement here (currently it’s 500 hours). Like any good organizational beaurocracy, the result of that was to appoint a committee to study the situation. The research they conducted was to ascertain whether or not students from schools with higher number of hours had a better pass rate on the exams than students from 500-hour schools. The answer to that was a big fat “no.”

I’m not sure how much money is being spent on this project; the first proposal I saw mentioned between $60-70,000 to be shared as an expense between the organizations. I urge, or rather, challenge, all of these organizations to pour an equal amount of money into the AFMTE Teacher Standards project. Improving the KSAs of entry-level educators—many of whom tend to be last year’s star students, who may be talented at massage but without a whit of experience and training in teaching methodology—will improve the KSAs of the students, the entry-level practitioners. That should be the important first step—the key word there being first. Don’t try to build a house without a good foundation. It’s a waste of time and money, and ultimately, it doesn’t work.

A Betrayal of Trust

Any time one of the major organizations in the massage field tries to fire up a project that will “advance the profession”, I get awfully suspicious. When a group of them get together to do something on the big scale, I go on full nuclear alert. That’s the case right now with a dubious education standards project introduced by ABMP in September 2011 at the Leadership Summit in St. Louis, which I detailed in my previous post, Behind Closed Doors.

As the title of that blog suggests, 100% of the activity surrounding this project has taken place in secret, with no information about the project being released to the massage therapy community—and no opportunities for review or comment before time, money and human resources are thrown at solving a perceived problem.

AMTA and FSMTB have signed on to this project, which will involve gathering information from the Federation’s upcoming Job Task Analysis survey, to use in a process that will “identify the rudimentary knowledge, skills, and attitudes required to pass a licensing exam and provide basic, but safe, massage in an early massage career.”

That doesn’t sound like a such bad thing—in and of itself—but the group intends to use this data to create an “evidence-based minimum educational requirement” for state licensing. This would be used as a rationale for changing state laws, and would likely be used to drive the curriculum standards for entry-level massage programs—basically telling schools what to do.

Goodness knows, there is a lot of inconsistency in massage education and regulation, but there is no problem in our profession that justifies one or a group of our so-called “stakeholder organizations” seizing the ball and marching down the field without our input or permission. I don’t give a rat’s you-know-what if they claim to be doing this in our best interests; this power play is a gigantic betrayal of trust. And I might add that I am personally in favor of the evidence-based practice of massage, but I don’t think one tiny group of people should get to decide what that is.

I’ve not yet been able to confirm the status of NCBTMB, Massage Therapy Foundation, AFMTE or COMTA as it relates to this project (mum’s the word all around). These four organizations, along with ABMP, AMTA and FSMTB just gathered on May 1-2 for another Leadership Summit—this time in Chicago. I’m taking bets that they will issue another sanitized press release that gives us regular folks in the bleachers little substance about what really happened in this meeting that has the potential to alter the very nature of our profession.

The only other info I’ve been able to glean is that ABMP, AMTA and FSMTB hand-picked a new workgroup of massage educators and other “experts” in instructional design and curriculum development to start this project on May 3-4, right after the completion of the Summit. Are you kidding me? Where was the public notice of this opportunity to serve on a panel that will influence the future of massage therapy? Who gave these organizations the authority to do this on our behalf?

No one. They took it on themselves, and that’s what stinks to high heaven.

In stark contrast, the Massage Therapy Body of Knowledge project had both fans and detractors, but it was carried out with a reasonable amount of transparency. The majority of the dissent on the project concerned the inclusion of energy work in the document and dissatisfaction with the way objections were handled—or not handled—in favor of evidence-based practices. The five organizations that comprised the MTBOK Stewards (ABMP, AMTA, FSMTB, MTF, NCBTMB) did a good job of not interfering with the project once it was launched.

Right now, we have a genuine crisis on our hands. The problem is that hardly anyone knows about it. This blog only goes so far. I never set myself up to be the New York Times of the massage field, but it seems like the major massage publications are afraid to get their teeth into the real breaking news that affects the practitioners, teachers, CE providers and schools that make this profession possible.

Friends, it’s up to YOU to let these organizations know that it’s not OK for them to act in your interest without your permission. As long as these “leaders” think they can get away with it, they will. Trust has been blown out of the water, and it will take a concerted effort to rebuild it.

A really good first step would be for ABMP, AMTA and FSMTB to release a full description of the project, including what they plan to do, how it will be done, who sits on the new workgroup, what the timelines are, and what money will be spent. And most importantly, we want to know what they intend to do with the “evidence”. When organizations that represent us are making major decisions that affect us, we deserve to be involved in the process.

Behind Closed Doors

From the title, you might think this blog is about The Client List, the trashy new show on the Lifetime Channel that gives massage therapy a black eye. No such luck; the event I am referring to is the upcoming Leadership Summit #2, set to take place next week in Chicago.

The first Leadership Summit (to clarify: there were summits in 2003-04 before AFMTE and FSMTB existed) took place last September in St. Louis, with the executive directors and chairs of ABMP, AFMTE, AMTA, the Massage Therapy Foundation, FSMTB, COMTA, and NCBTMB in attendance. It was a historic event in that it was the first time all seven of these organizations had come together in the best interests of the profession. The purpose, according to the press release announcing the meeting, “was to hold a beginning conversation about major structural issues and impediments to profession progress. The desire is to have candid exchange about core challenges, quality concerns, consumer expectations and organizational roles.”

Apparently, one of the hot topics at this week’s meeting is going to be the number of required entry-level education hours. Although this was not on the agreed-upon agenda at the first meeting, it was introduced anyway by ABMP Chairman Bob Benson, complete with a thorough proposal prepared by Anne Williams, Director of Education at ABMP. Basically, the proposal was for a task force to be formed immediately, and using Job Task Analyses that have been conducted by the NCBTMB and the FSMTB, to nail down a definite number of hours that should be required for entry-level education. This was contrary to the facilitator’s recommendation—and the group’s agreement— that they would spend the initial meeting identifying problems, and would address possible solutions for these problems at meetings to follow.

In the interest of the leaders being comfortable in speaking freely, these are closed meetings—no press and no other staff members in attendance—an executive session, so to speak. Certainly not without precedent; boards have executive sessions all the time—usually to discuss personnel matters or other things that would violate someone’s privacy if they were discussed in public.

That’s not exactly the case here; and while I am thrilled that our leaders—some of whom are from competing organizations—are sitting down at the table together, my concern is that a small group of people has the power to decide (or worse, just think they have the power to decide), what is best for the profession on the whole, without getting input from the people it affects—you and me. Practitioners, school owners, teachers, CE providers, the regulatory community, all have a vested interest in the future of our profession, and I don’t think that should be decided by an exclusive group behind closed doors.

Unfortunately, that is just what the ABMP proposal states in no uncertain terms. Verbatim, Williams’ proposal stated: There is no step in this proposal to obtain input from the broader massage profession or from other health-care or bodywork organizations during this project. The reason is simple—the work group is simply performing a work task in writing learning outcomes and objectives for job tasks defined by surveys already conducted by FSMTB and NCBTMB. It doesn’t matter what stakeholders, or other groups think should be taught or shouldn’t be taught. The work group would be responding to what therapists report they do, on a day-to-day basis, in their massage-related environments as part of their jobs.

The sentence that disturbs me there is “It doesn’t matter what stakeholders, or other groups think should be taught or shouldn’t be taught.” Any time you start to think it doesn’t matter what stakeholders think, there’s a problem, in my humble opinion, no matter what the issue. Stakeholders are the ones it will affect, and to think their opinion isn’t important is just beyond the pale.

At the recent ABMP School Issues Forum in Austin, Texas, Bob Benson stated to those in attendance that there was 100% consensus in support of this standards-setting proposal from the organizations that attended the Leadership Summit. That’s not exactly so. COMTA, FSMTB, and AFMTE all expressed concerns after the proposal was introduced in September; they are not petty concerns, and they do not appear in any way to be based on politics or turf wars.

This is bad business for two primary reasons: First, any project that has the potential to affect the entire massage therapy profession should not be designed, approved, and launched in secret. Changing the baseline numbers of entry-level education required for state licensure is a huge thing, as it will affect schools, regulators, and future students.

By contrast, the MTBOK project modeled appropriate transparency, and the massage community had adequate opportunities for input along the way.

Second, it is more important right now that our primary stakeholder organizations learn to work together in an atmosphere of trust and cooperation—than to plunge headlong into a major problem-solving project when consensus has NOT been reached. The end does not justify the means. Some of my own issues are that the MTBOK and the competency-based curriculum standards set forth by COMTA aren’t even being given consideration. This proposal also overlooks the fact that the AFMTE is currently working on a National Teacher Standards Education Project. A huge amount of work has gone into creating both the MTBOK and the COMTA standards; a huge amount of work from some of the best educators in the business is going into the AFMTE project, and for these to be cast aside when they have direct relevance to this proposal is irresponsible to say the least.

During our troublesome economy of the past few years—and it doesn’t appear to be over yet—school owners have been seriously affected already, and having a nation-wide upheaval based on an “official” number of required hours is not the be-all end-all solution to licensing portability. It will just serve to put an additional burden into the mix at the present time. The lack of portability may be an irritant to our field, but it is not causing harm to the public.

The AMTA Board of Directors voted last October to support the project in its present form. As ABMP and AMTA are the two largest professional membership associations, they carry a big stick. That doesn’t mean their agendas should be force-fed to the profession, and I hope that they will reconsider both the timeline, and the very valid concerns raised by the other organizations before barging ahead with this project. I am certainly not saying that it never needs to happen. I am just saying it doesn’t need to happen on speed-dial until all of these issues have been ironed out. I hate to see good intentions canceled out by unchecked enthusiasm for rushing something to market; I hate to see valid concerns from the other organizations swept under the carpet; and I hate to see the opinion that what the stakeholders think doesn’t matter.

When you’re meeting behind closed doors, it’s easy to forget who the stakeholders are. I’m one of them. I’m a member of both AMTA and ABMP, a founding member of the AFMTE, a past delegate to the FSMTB, a Nationally Certified Massage Therapist & Bodyworker, an Approved Provider under the NCBTMB, and a current site reviewer for COMTA, so I do indeed have a vested interest. I don’t appreciate our national organizations acting as if my opinion and that of the other thousands of massage therapists, school owners, and others who enable your very existence on this planet don’t matter.

At this week’s Summit, the representatives of these seven organizations have an opportunity to address this issue that has divided the group, and to get their process back on track. I hope that they also remember the responsibility that they have to their own members, and to the profession as a whole. To use ABMP’s own slogan here, we “Expect More” from our leaders.

CAMTC Responds to “Money Grab” Accusation from Massage Today

Update 09/19/2025: Massage Today was a long-standing industry publication that was bought by AMTA several years ago. The publication no longer exists, but there are some of the articles archived on the AMTA website. Most deal with anatomy, techniques, and business. No editorials or blogs are archived, so the article this blog refers to no longer exists. Lo these many years later, I agree with Peterson and the CAMTC is STILL on a money grab. The original blog is below:

Last week, Massage Today President Donald Peterson published an article entitled The CAMTC Money Grab. It cast the CAMTC in a very unfavorable light; to make a long story short, it appeared to expose excessive financial wrongdoing at the organization by stating that the CAMTC was paying the expenses and per diem for no less than 14 board members to attend the American Massage Conference. The AMC is a moveable event that is held each year in a different location, and this year’s event was taking place in San Diego.

Peterson backed up his claims of financial excess with a table showing who voted to spend the money and who didn’t, and also stated that Massage Today Senior Associate Editor Kathryn Feather had actually been on the CAMTC conference call when the vote was taken about spending the money. The criticism was that although it was not unanimous, that for the most part the people who voted to spend it were the people who were going to receive it. In reality, that’s the way it goes on all boards; board members vote on things, and that includes where and when to attend events and how much money will be spent on it, so there’s really nothing unusual about that.

I shared this article on my Facebook page, and immediately started hearing from board members of the CAMTC that Peterson’s story was very biased and not telling all the facts. Since I initially shared it and contributed to giving a bad impression of the organization, I made the offer to them that I would give them equal time on my blog to present their side of the story. The fallout from this has been swift, not the least of which is the resignation of Keith Eric Grant from the magazine, which he has been contributing to since 2002. Grant is a CAMTC board member, and someone I  have admired as a writer, a scientist, and a person from afar. He has been blogging about the politics of massage way before I started. I haven’t had the opportunity to meet him in person, but we have been FB friends for several years, and as I stated on my page, I would believe pigs would fly before I would believe that he would misrepresent the truth.

Grant’s response to the Massage Today article can be read in its entirety here.  Note: Grant’s response is still on his website. 

I also immediately heard from Joe Bob Smith, another CAMTC board member, whom I have personally met several times. Joe Bob’s response to my sharing the article on FB was this:

Laura, sometimes your quick fingers get something going without hearing from the other side. As a CAMTC board member, I believe that Massage Today wrote a biased piece with missing and incorrect information. I’ll be happy to defend the actions of the board any day. The CAMTC is made up of 20 terrific volunteers, many working massage therapists themselves. They put a lot of their own time (and time is money) into this organization. Many will be losing money by volunteering at the AMC. They deserve to be reimbursed for out of pocket travel expenses when on board business. And the per diem limit is $211/day (standard government established rates) which includes hotel, not just food. The CAMTC has a very proactive, working board that has done a lot to curb prostitution and human trafficking in the two and a half years it’s been in existence. I do hope you’ll seek me out next time you hear of CAMTC news. While we all have differences of opinions, I would like to make sure the other side gets at least equal opportunity.

I also heard from Mark Dixon, Vice Chairman of the CAMTC. His response to my offer to tell the CAMTC side of the story is printed here verbatim, and was actually his response to Kathryn Feather’s questioning him as to why he voted to support the members being reimbursed, and what his duties would be:

The importance of attending this meeting and interfacing with those attending is reinforced by my continuous attendance at national and statewide conventions of this type since 1975. My comments are strictly related to the question asked, and are about my own participation. It’s not hard, though, to extrapolate that purpose to the other volunteers who will attend the AMC.

Regretfully, CAMTC’s CEO, Ahmos Netanel, has been asked to return his attention to more pressing issues affecting CAMTC, and is unable to reply to your offer.
 
My response to Kathryn:
 
As I stated during the debate, I’d agree with the two other entities in disagreement if the event were anywhere but in California. But in San Diego there will be roughly 2000 local massage therapists and affiliated bodyworkers in attendance who either provide or manage massage services. In addition, the venue provides a valuable opportunity to network with influential individuals from around the country who have expressed strong interest in California’s unique massage regulation; in short, a chance to learn, teach and network in a setting that rarely comes to our state.
 
My specific duties include but will not be limited to meeting with counterparts from other state boards and professional organizations, directing participants to the specific part of the CAMTC that is most helpful to them, assisting with coverage of our exhibit, and following up/developing contacts during the years to come. I expect to be on duty from Friday morning to Sunday afternoon and plan to take one three-hour class at my own expense.
 
As the first meeting of this type attended by the CAMTC, I believe the small investment is a sound one that will place experienced, knowledgeable professionals before an important audience. I’ve been working meetings of this type since 1975, and have learned that a highly concentrated group of individuals in a convention setting affords an excellent opportunity to save considerable expense of travel and lodging.
 
Even so, as a volunteer I stand to lose considerably more in income than the reimbursement. Moreover, I attended last month’s AMTA-CA Chapter Educational Conference, representing CAMTC in continuous meetings throughout the weekend. I received zero reimbursement.

 

Although as Dixon said, CAMTC Executive Director Ahmos Netanel was too busy to reply to my offer to personally tell the other side of the story, Massage Today did print an e-mail that he sent to Peterson in response to the article. It is quite lengthy and can be read in its entirety here.

In summary, Netanel accused Massage Today of misrepresenting the facts in a biased and inflammatory way, and withholding information that would have cleared up the accusations to begin with. By the looks of Netanel’s rebuttal, this article would probably have never gone to print–at least not in its present form–had his responses been considered before the magazine went to press.

Since I’ve been accused of being inflammatory myself–and rightly so, at times–and because I shared the Massage Today article on my FB page, I felt compelled to present the CAMTC side of the story. In fact, Keith Eric Grant and Joe Bob Smith have both occasionally called me on the carpet over something, and I don’t resent that. Although I certainly have my own opinions and biases, it is never my intention to be so biased that I can’t see both sides of the story, or at least give them equal consideration. And like a lot of things, there’s one side, there’s the other side, and somewhere in the middle is the actual truth.

I will also state, in the interest of self-disclosure, that during my five years on the North Carolina Board, I was sent to several conventions on their behalf, and they paid my way. Board members on any board generally give up their own time to volunteer when they could be making substantially more money than the per diems allowed by boards (and in fact some don’t pay a per diem at all), not to mention their time away from their own families, businesses and other activities in the interest of service to the organization. I’m the office manager/receptionist at my own office, and every time I attended a board meeting, I had to pay someone to take my place. My per diem ($100 per day) didn’t come close to covering that, or the inconvenience of driving almost five hours both ways to attend a meeting. While it’s true that there is always going to be some abuse taking place somewhere, I believe that’s the exception and not the rule, and I don’t think this particular incident was a case of abuse of board funds. Mark Dixon quoted the late great Paul Harvey, who always signed off by saying “and there you have the rest of the story.”

My blog is my own opinion, and should not ever be considered to be the opinion of anyone else.

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